Lymph node count at radical cystectomy does not influence long-term survival if surgeons adhere to a standardized template

Urologic Oncology
Elisabeth E Fransen van de PutteS Horenblas

Abstract

Multiple bladder cancer studies report that the number of removed lymph nodes (lymph node count [LNC]) at radical cystectomy (RC) is positively associated with survival. Although these reports suggest that LNC can be used as a proxy for surgical quality, all studies used variable or inconsistent pelvic lymph node dissection (PLND) templates. We therefore wished to establish whether LNC at RC influences survival if surgeons adhere to a standardized PLND template. We included 274 patients who underwent RC from January 2005 until December 2012. All RCs were performed in either one of 2 hospitals (hospital A or B) by the same 4 urologists (all from hospital A) and a standardized PLND template was applied. PLND specimens were processed by 2 independent pathology departments (hospital A and B). We used Cox regression analysis to investigate the prognostic value of LNC adjusted for patient characteristics. We also compared LNC between hospitals and surgeons and investigated the effect of both the variables on overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS). Median LNC was 17 (interquartile range = 12). At a median follow-up of 64.3 months, there was no association between LNC and OS (P = 0.328), ...Continue Reading

References

Jun 17, 2004·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Harry W HerrE David Crawford
Sep 13, 2011·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Jennifer GordetskyJorge L Yao

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Citations

Mar 25, 2020·Current Opinion in Urology·Hyun Hwan Sung, Seth P Lerner
Dec 25, 2017·International Urology and Nephrology·Mahir MarufPiyush K Agarwal

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